Background: The prevention of Fetal Alcohol Syndrome and fetal alcohol exposure is an important national priority. A 1995 national survey conducted by the Centers for Disease Control estimates that as many as 140,000 children born in the US are exposed to. potentially harmful effects of alcohol. during fetal development (3.5% of 4 million live births). One prevention strategy is to establish screening and intervention procedures that can be administered in primary care settings to women who are drinking above recommended limits. Goal: This study is designed to test the efficacy of a primary care-based brief intervention for women who resume heavy drinking during the post partum period and who used alcohol during their last pregnancy. The ultimate goal is to reduce alcohol use, alcohol-related harm, and fetal alcohol exposure in subsequent pregnancies. Method: The trial will utilize methods successfully employed by the PI in three brief intervention trials (Project TrEAT, Project GOAL, and an ongoing trial in Poland). Women will be asked to complete an embedded alcohol questionnaire (Health Screening Survey) while seeing their obstetrician for a routine post partum visit. Women who screen positive for heavy drinking (>7 drinks/week in the past month, 4 or more drinks/occasion, or two or more positive responses on the T-ACE) will be invited by a researcher to participate in a health interview. Women who meet eligibility criteria for the trial will be randomized to a usual care control group or a physician/nurse brief intervention group. The intervention will consist of two 10-15 minute physician/nurse visits and two 2- minute follow-up phone calls. All subjects will be contacted at 6, 12, 18 and 24 months by telephone to assess outcomes of interest which include alcohol use, quality of life, mental health problems, accidents, and health care utilization. Power analysis suggests that 250 women in each arm of the trial will have sufficient power to detect a difference for the main outcome variables of interest. Significance: The proposed study would significantly increase our understanding of how to reduce alcohol use in post partum patients and how to limit FAS and fetal alcohol exposure.